Australian Mental Health Outcomes and Classification Network
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Health of the Nation Outcome Scales for Infants - HoNOSI

The NOCC Strategic Directions 2014- 2024 Final Report included a number of recommendations relating to child and adolescent mental health services, in particular Recommendation 11 highlighted the need for the development of a measure for infants and pre-schoolers (those 0-47 months). The NOCC Strategic Directions Implementation Plan identified the Child and Adolescent Mental Health Information Development Expert Advisory Panel (CAMHIDEAP) as being best placed to guide this work, supported by the Australian Mental Health Outcomes and Classification Network (AMHOCN).

CAMHIDEAP conducted a literature review to determine whether there were any suitable measures already available. This work identified several measures that had potential for use with the age group; however some issues were noted e.g. no one tool covered the entire 0-47 month age band; some measures had cost implications regarding use.

CAMHIDEAP noted that serious consideration was being given by others in the sector to modification of the Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA) for use with infants. Work was therefore undertaken to develop the Health of the Nation Outcome Scales for Infants (HoNOSI). It was determined that a measure based upon the 15 item format of HoNOSCA might better facilitate the incorporation of HoNOSI into mental health information systems. 

A draft HoNOSI was developed by an expert working group and this was followed by:

  • initial sector consultation;
  • further measure modification;
  • face validity testing;
  • additional measure modificiation informed by face validity testing; and
  • a field trial to test selected psychometric properties of the measure (concurrent validity and inter-rater reliability).

The face validity testing found that clinicians were positive about the measure and expressed both a want and a need to use it. The concurrent validity study findings were positive and acceptable and there was strong evidence of inter-rater reliability. These results support the release of the HoNOSI. You can download a copy of the Final Report of the development of HoNOSI.

The measure is now available for use. You can view a sample copy of the HoNOSI. However, if you would like to access and use the HoNOSI, please complete the licence application form. You will then be able to download the HoNOSI for use in your organisation.

To support use of the HoNOSI, AMHOCN has developed an online training module. The module gives an overview of each of the scales of HoNOSI. Participants then practice rating the HoNOSI and complete a short quiz.

If you have any questions, please do not hesitate to contact AMHOCN by email.